Related Experiment Video
Updated: Aug 31, 2026
A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
Published on: February 18, 2022
Clinical profile of chronic heart failure in elderly women
Suman Tandon1, Shelley R Hankins, Thierry H Le Jemtel
1Department of Medicine, Division of cardiology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Insights
Elderly women with chronic heart failure (HF) often experience diastolic dysfunction due to unique cardiac remodeling. Current heart failure guidelines may not apply, necessitating targeted research for this demographic.
Area of Science:
- Cardiology
- Geriatrics
- Cardiovascular Disease
Background:
- Chronic heart failure (HF) management is often based on clinical trials with predominantly male participants, potentially limiting applicability to female populations.
- Elderly women with HF exhibit distinct pathophysiological characteristics compared to the typical trial populations.
- Landmark HF trials primarily included younger male patients, differing significantly in age and sex from the prevalent HF demographic in the United States.
Purpose of the Study:
- To highlight the differences in pathogenesis, clinical course, and treatment of chronic HF in elderly women compared to established trial data.
- To investigate the underlying mechanisms of HF in elderly women, particularly the role of diastolic dysfunction.
- To emphasize the need for sex-specific considerations in HF research and clinical guidelines.
Main Methods:
- Analysis of existing literature and clinical data focusing on gender-specific differences in chronic heart failure.
- Comparison of left ventricular (LV) remodeling patterns in response to chronic pressure overload between men and women.
- Evaluation of the impact of LV wall thickness on diastolic and systolic function in elderly women with HF.
Main Results:
- Diastolic dysfunction, characterized by impaired left ventricular (LV) filling, is the primary functional alteration in elderly women with chronic HF.
- Elderly women develop thicker LV walls in response to chronic pressure overload compared to men.
- This increased LV wall thickness allows women to better preserve LV systolic function but leads to impaired LV filling.
Conclusions:
- Clinical guidelines and observations derived from male-predominant HF trials may not be directly applicable to elderly women.
- Gender differences in cardiac remodeling significantly influence the presentation and pathophysiology of HF in elderly women.
- Future HF therapeutic trials must include substantial numbers of elderly women to generate evidence-based management strategies.
Abstract:
The pathogenesis, clinical course, and treatment of chronic heart failure (HF) are different in elderly women from those of patients recruited in the landmark trials of chronic HF. Patients included in these landmark trials were predominantly men whose age was 10-15 years younger than the average age of patients with chronic HF in the United States. Diastolic dysfunction resulting in impaired left ventricular (LV) filling is the preponderant LV functional alteration that leads to chronic HF in elderly women. Gender differences in the LV remodeling process that accompanies chronic cardiac pressure are likely to be responsible for the preponderance of LV diastolic dysfunction over systolic dysfunction in elderly women. In response to chronic pressure overload, the LV wall becomes thicker in women than in men. Consequently, in response to chronic pressure overload, women are able to normalize LV wall stress and preserve LV systolic function to a greater extent than men. However, impaired LV filling is an undesirable consequence of the greater increase in LV wall thickness in women. Thus, clinical observations and therapeutic guidelines derived from data collected in the landmark trials of chronic HF may not apply to elderly women with chronic HF. In view of the lack of evidence-based information needed to guide the management of elderly women with chronic HF, special attention should be given to include a substantial number of elderly women in future therapeutic trials recruiting patients with chronic HF.
More Related Videos
04:05Clinical Application of Phase Angle and BIVA Z-Score Analyses in Patients Admitted to an Emergency Department with Acute Heart Failure
Published on: June 30, 2023
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:27Heart Failure I: Introduction
01:29Heart Failure II: Pathophysiology
01:26Heart Failure III: Clinical Manifestations
01:30Heart Failure IV: Classification and Diagnostic Evaluation
01:30Heart Failure VII: Nursing Interventions